Journal of Andrology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published-Ahead-of-Print January 8, 2009, DOI:10.2164/jandrol.108.006437

This Article
Right arrow Author Manuscript (PDF)
Right arrow All Versions of this Article:
30/3/280    most recent
Author Manuscript (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pectasides, D.
Right arrow Articles by Economopoulos, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pectasides, D.
Right arrow Articles by Economopoulos, T.

Testicular Function in Poor-Risk Nonseminomatous Germ Cell Tumors Treated with Methotrexate, Paclitaxel, Ifosfamide, and Cisplatin Combination Chemotherapy

Dimitrios Pectasides *, Eirini Pectasides , George Papaxoinis , Maria Skondra , Maria Gerostathou , Sofia Karageorgopoulou , Constantinos Kamposioras , Nikolaos Tountas , Anna Koumarianou , Amanda Psyrri , Anastasios Macheras , and Theofanis Economopoulos

* To whom correspondence should be addressed. E-mail: pectasid{at}otenet.gr.

The objective of this study was to investigate the impact of methotrexate, paclitaxel, ifosfamide and cisplatin (M-TIP) on long-term fertility in poor-risk nonseminomatous germ cell tumors (NSGCT). Thirty patients with poor-risk NSGCT (median age, 29 years; range, 17 to 62 years) were treated with methotrexate 250mg/m2 with folinic acid rescue (day 1), paclitaxel 175mg/m2 (day 1), followed by ifosfamide 1.2g/m2, and cisplatin 20mg/m2 (days 2-6). Treatment consisted of 4 cycles of M-TIP administered every 3 weeks. Twenty one patients are continuously disease-free at a median follow-up of 5.3 years (range 0.9-8.4+ years). Sperm count and hormonal analyses were examined pre- (30 patients) and post-chemotherapy (21 patients). Counts were classified as follows: < 1 x 106/ml azoospermia (AS), 1-20 x 106/ml oligospermia (OS), > 20 x 106/ml normospermia (NS). Patients were followed for a median of 2.3 years (range, 0.9-3.8 years) post-chemotherapy. The pre-chemotherapy median luteinizing hormone (LH) serum levels were slightly above the upper normal limit, while the serum levels of follicle stimulating hormone (FSH) and testosterone (T) were within the reference interval. Eleven (52.3%) patients had NS pre-chemotherapy. Among the NS patients, 72.7% remained NS following chemotherapy. Overall, 17/21 (80.9%) (33.3% OS and 47.6% NS) patients had recovery of spermatogenesis after treatment. The median FSH serum levels were significantly elevated at least 1 year post-chemotherapy when compared with the pre-treatment levels. Eighteen months after the completion of chemotherapy the median FSH levels had returned to the reference limits. Serum LH and T levels were unaffected by chemotherapy. Prior to chemotherapy 4 of 30 patients had fathered 5 children. Since completion of chemotherapy 5 patients have fathered 5 children. The majority of men with poor-risk GCT who were treated with the M-TIP regimen demonstrated recovery spermatogenesis after treatment, while Leydig cells function was unaffected.


Key words: Fertility • cisplatin • gonadal toxicity • ifosfamide • methotrexate • nonseminomatous germ cell tumors




This article has been cited by other articles:


Home page
 Molecular Cancer TherapeuticsHome page
R. Tripathi, T. Samadder, S. Gupta, A. Surolia, and C. Shaha
Anticancer Activity of a Combination of Cisplatin and Fisetin in Embryonal Carcinoma Cells and Xenograft Tumors
Mol. Cancer Ther., February 1, 2011; 10(2): 255 - 268.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2009 by The American Society of Andrology.